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Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England

Sohal, Harpreet; Huddlestone, Lisa; Ratschen, Elena

Authors

Harpreet Sohal

Lisa Huddlestone lisa.huddlestone@nottingham.ac.uk

Elena Ratschen



Abstract

Introduction: Despite high smoking prevalence and excessive smoking-related morbidity and mortality among people with mental disorder compared to the general population, smoking treatment is often neglected in mental health settings. The UK National Institute of Health and Clinical Excellence (NICE) recently issued public health guidance stipulating completely smoke-free mental health settings. This project evaluated existing smoking-related practices in preparation for guidance implementation. The objectives were to: audit the recording of smoking-related information and treatment provision; explore current arrangements relating to the facilitation of patient smoking; measure staff time spent and identify costs of facilitating smoking; and explore the role of smoking in smoking-related incidents.

Methods: A mixed-methods study was conducted across four acute adult mental health wards, accommodating 16 patients each, over six months. It included a case-note audit, on-site observations, and a qualitative content analysis of incident reports.

Results: Smoking status was recorded for less than half of the 290 patients admitted (138, 48%). Of those, 98 (71%) were recorded as current smokers, of whom 72 (74%) had received brief smoking cessation advice. Staff spent 6028 h facilitating smoking, representing an annual cost of £131,040 across four wards. Incident reports demonstrated that smoking facilitation was often central to the cause of incidences, triggered frustration in patients, and strained staff resources.

Conclusion: The findings highlight the importance and potential of implementing completely smoke-free policies using comprehensive pathways.

Journal Article Type Article
Publication Date Feb 25, 2016
Journal International Journal of Environmental Research and Public Health
Electronic ISSN 1660-4601
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 13
Issue 3
APA6 Citation Sohal, H., Huddlestone, L., & Ratschen, E. (2016). Preparing for completely smoke-free mental health settings: findings on patient smoking, resources spent facilitating smoking breaks, and the role of smoking in reported incidents from a large mental health trust in England. International Journal of Environmental Research and Public Health, 13(3), https://doi.org/10.3390/ijerph13030256
DOI https://doi.org/10.3390/ijerph13030256
Keywords Smoking; Mental health; Mental disorder; Tobacco dependence; Psychiatric settings; NICE PH48; Smoking cessation; Nicotine dependence; Smoke-free policy
Publisher URL http://www.mdpi.com/1660-4601/13/3/256
Related Public URLs http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808919/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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